Obesity Is About Much More Than an Unhealthy Lifestyle

Senior Research Fellow in Public Health and Obesity, Leeds Beckett University

A non-stigmatising image on the left, and a stigmatising image on the right. Canadian Obesity Network/Shutterstock

Despite an abundance of evidence illustrating that weight gain is caused by a complex cocktail of factors, obesity is often solely attributed to poor individual lifestyle choices – such as diet and exercise.

This type of simplistic view of what causes weight gain leads to and reinforces what’s known as “weight stigma”. This is defined as:

A bias or discrimination aimed at individuals perceived to be overweight.

But this isn’t something that just impacts people of a certain weight. In fact, weight stigma affects people of all body shapes and sizes – including people classed as a healthy weight.

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These types of attitudes, of course, aren’t helped by the fact that fat jokes, as well as stereotypical and derogatory images of overweight people are so common. For a start, think about TV soaps – research has shown that characters with excess weight have more negative experiences, fewer friendships, and less romantic relationships when compared to characters of a healthy weight.

This can be seen in The Times’ recent article, which has the headline “Heffalump Traps will Clear the NHS of Fatties” – clearly highlighting that people with obesity are stereotyped and in many cases, belittled.

Reports in newspapers are often on the “controllable causes” of weight gain, such as dietary behaviors, with little mention of so-called “uncontrollable causes” – like portion upselling, food formulation, and food advertising.

Research looking at the way national newspapers in the UK portray obesity also shows that 98% of articles inform readers it is something that is controllable. This leads people to believe that being overweight is caused only by poor lifestyle choices, and is fundamentally solved by being more active and eating a healthier diet. The reality, of course, is very different and extremely complicated.

What’s more, these newspapers are collectively read by millions of people. Such articles both reinforce and endorse stigmatizing attitudes and discriminatory behaviors towards people with obesity. It sends the message out loud and clear that it’s acceptable to judge people based on their body weight.

Even healthcare services aren’t immune to this type of weight stigmatization – it has been suggested that patients may be denied bariatric surgery due to the biased attitudes of surgeons.

These types of attitudes are also clearly evident in government policy. In 2011, Andrew Lansley, the Secretary of State for Health, said:

We need to be honest with ourselves and recognize that we need to make some changes to control our weight. Increasing physical activity is important but, for most of us who are overweight and obese, eating and drinking less is key to weight loss.

Whether you’re a politician or a medical professional, it doesn’t necessarily make you immune to popular belief and media misconception.

Overcoming discrimination

But beyond all of this, weight stigma is doubly damaging because it not only negatively impacts people who are overweight, but it further hinders the likelihood of countries taking effective action. This system-wide action would see the creation of a health-promoting environment – one that is free of stigma and individual blame. The responsibility for obesity must be shared between society and the individuals within it.

The use of non-stigmatising images can help reduce weight discrimination. Canadian Obesity Network, CC BY-NC-ND

This is an important step because negative images can greatly impact people with obesity on a daily basis, which can lead many to feel depressed about their physical appearance.

Only by accurately reflecting the realities of obesity – that it is a chronic disease caused by both controllable and uncontrollable factors – can we move towards establishing an effective solution. Given that a UK based research study from 2015 found that adults of all ages and backgrounds have stigmatizing attitudes towards those with excess weight, this is clearly something that needs to be tackled sooner rather than later.